Pharmacological profile of elderly diabetics in Campinas, São Paulo, Brazil

INTRODUCTION:  The therapeutic scheme for elderly diabetics and younger patients involves glycemic control with nonpharmacological measures such as changes in eating habits and physical activity. When these measures are not enough, starts using drugs in single or combined therapy. The physiology of the elderly differs from adults and the prevalence of comorbidities is much larger, resulting in a greater use of medicines, in the polypharmacy, potential drug interaction and in the use of inappropriate drugs for the elderly.

METHODS: Cross-sectional population-based study with 333 elderly (60 years and older) living in Campinas, São Paulo, Brazil in 2008 /2009. The data are from the "Survey of Health in Campinas" (ISACamp). The drugs used in the three days preceding the survey were classified according to the Anatomical Therapeutic Chemical Code (ATC-2009). Possible drug interactions were evaluated using the Drugs.com classifying the main interactions: Major, Moderate and Minor. All statistical analyzes were performed using Stata 11.0 survey module of the program.

RESULTS:  Among elderly diabetics, 96.8 % used at least one drug and 41.7% reported use of five or more in the three days preceding the survey. Among the five most common drugs are oral hypoglycemic metformin (11.7%) and glibenclamide (7.5%); two antihypertensive drugs: captopril (10.4%) and hydrochlorothiazide (5.4%) and inflammatory and antithrombotic acetylsalicylic acid (7%). In the analysis of interactions (n = 937) 87.5% were moderate, 10% minor and 2.5% major. In moderate interactions, stand out captopril+metformin, glibenclamide+captopril and captopril+ hydrochlorothiazide, with use reported by 16.8%, 16.1% and 13.2% of the elderly, respectively.

CONCLUSIONS: Elderly diabetic requires attention in drug therapy and the prescription is necessary to prevent the occurrence of interaction, highlighting the risk of major interactions and the high frequency of moderate as well as monitoring and reporting on possible warning signs.